Fri Jan 24 2025

96 articles - From Friday Jan 17 2025 to Friday Jan 24 2025

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Aliment Pharmacol Ther

Rome Foundation Working Team Report: Consensus Statement on the Design and Conduct of Behavioural Clinical Trials for Disorders of Gut-Brain Interaction.

This working team report facilitates a shared understanding of the elements of scientific rigour necessary for BGBT development and could support future standards on which BGBT are evaluated in gastroenterology.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Network Meta-Analysis: Comparison of Endoscopic Dysplasia Detection Technologies in Inflammatory Bowel Disease.

HD-WLE-SR, DCE and CEM demonstrated superiority over other techniques for detection of dysplasia in colonic IBD. DCE was superior for dysplasia detection in colonic IBD. DCE was superior to HD-WLE in colonic IBD. DCE was the best technique in UC. Further studies to compare HD-WLE-SR and NBI with DCE are warranted to ascertain performance equivalency and define the optimal surveillance technique.

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Gastroenterology

Eradication Therapy to Prevent Gastric Cancer in H. pylori-positive individuals: Systematic Review and Meta-analysis of Randomized Controlled Trials and Observational Studies.

This meta-analysis provides further evidence that administering eradication therapy prevents gastric cancer in H. pylori-positive individuals, with consistency in results among studies of different design.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Disparities in Alcohol-Associated Liver Disease Hospital Encounters Amongst a Texas-Based Cohort of Patients.

The highest increases of alcohol-associated encounters were observed amongst young Hispanic and NHB women, highlighting variation in trends by age, sex, race and ethnicity. These disparities merit further investigation to elucidate underlying mechanisms and develop tailored interventions to improve ALD burden and outcomes.

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Head-to-Head Comparison Between Phosphatidylethanol Versus Indirect Alcohol Biomarkers for Diagnosis of MetALD Versus MASLD: A Prospective Study.

PEth outperforms previously used non-invasive tests in differentiating MetALD from MASLD and has the potential to change clinical practice by enhancing the subclassification of SLD.

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Obesity Is Associated With Worsened Outcomes in Patients With Ulcerative Colitis on Advanced Therapies: A Propensity Matched Cohort Study From the U.S.

Obesity is associated with lower efficacy of several advanced therapies in patients with UC.

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Retrospective Cohort Study: Scope for Improvement-Barriers to Post-Polypectomy Surveillance in the Integrated Technologies for Improved Polyp Surveillance Cohort.

Patients from more socioeconomically deprived areas are less likely to have appropriate post-polypectomy surveillance, and are more likely to have metachronous polyps and colorectal cancer even when they do. Conclusion Surveillance strategies must take into account factors including socioeconomic deprivation and comorbidity exist to improve surveillance uptake in this group through the design of targeted interventions which move away from the current "one size fits all" approach.

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Am J Gastroenterol

Clinical Outcomes in A Multi-center Cohort Involving 919 Patients with Hypertriglyceridemia-associated Acute Pancreatitis.

Using a multi-center cross-regional cohort, we demonstrated that HTG-AP had a higher risk of developing severe AP and organ failure. A risk prediction model for predicting severe AP was developed and effectively stratified patients.

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Discovery of Methylated DNA Biomarkers for Potential Non-Endoscopic Detection of Barrett's Esophagus and Esophageal Adenocarcinoma.

This discriminatory biomarker panel algorithm exemplifies a practical nonendoscopic strategy to diagnose BE, HGD, and EAC using a minimally-invasive sponge-capsule device coupled with DNA methylation markers.

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ENHANCEMENT OF CIRRHOSIS MORTALITY PREDICTION BY INCLUDING HEPATIC ENCEPHALOPATHY TO MELD3.0 IN A NATIONAL VETERAN COHORT.

The addition of HE to MELD3.0 and MELD-Na significantly improved their mortality prediction with interactions at 90-days and 1-year on multivariable regression. A documented inpatient HE episode is additive to the mortality prediction of MELD3.0 by 4-5 extra points and could enhance future MELD iterations.

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High Cirrhosis Surgical Volume Centers have Reduced Postoperative Mortality in Patients with Cirrhosis Undergoing Major Surgery.

In this retrospective cohort study of 14,500 major surgeries in patients with cirrhosis, we found in adjusted analysis that high-volume centers (>16 surgeries in past year) had a 36% reduced hazard of post-operative mortality through 90 days versus low-volume centers (<9 surgeries in past year; hazard ratio 0.64, 95% confidence interval 0.43-0.94, p=0.02). These findings demonstrate the importance of triaging patients with cirrhosis to high-volume centers for major surgery when feasible.

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Higher Relapse Rate in HBeAg-negative Patients After Cessation of Tenofovir Alafenamide Compared to Entecavir or Tenofovir Disoproxil Fumarate.

There is an earlier and higher HBV relapse rate in patients who discontinue TAF therapy than in comparable patients discontinuing entecavir or TDF therapy. Close monitoring is necessary after TAF withdrawal, particularly in the first 3 months.

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Medications for Alcohol Use Disorder Are Increasingly Being Prescribed in American Patients with Advanced Liver Disease.

The rate of AUD medication discontinuation for adverse events was similar in both groups (14% vs 12%). Naltrexone, acamprosate, and disulfiram are increasingly being prescribed in American patients with mild and severe ALD with similar tolerability and efficacy.

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Periodontitis and the incidence of inflammatory bowel diseases: A nationwide population-based cohort study.

Periodontitis may augment the risk of incidence for CD and UC. This association underscores the potential significance of periodontal health in the context of IBD, emphasizing the importance of comprehensive oral hygiene practices and potential preventive strategies to reduce the risk of CD and UC incidence.

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Prevalence and clinical impact of the London classification: a prospective, international, multicenter study from the Lower Gastrointestinal International Consortium (LoGIC).

This prospective multicenter study provides information on the prevalence and clinical impact of the London classification, and will guide refinement of the current London classification.

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Clin Gastroenterol Hepatol

Gender-Equity Model for Liver Allocation using Artificial Intelligence (GEMA-AI) for waiting list liver transplant prioritization.

The use of explainable machine learning models may be preferred over conventional regression-based models for waiting list prioritization in LT. GEMA-AI made more accurate predictions of waiting list outcomes, particularly for the sickest patients.

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Endoscopy

Outcomes of Endoscopic Submucosal Dissection for High-Risk Colorectal Colitis-Associated Neoplasia in Inflammatory Bowel Disease.

Post-resection surgery was required in 11.5% (95%CI 0.114; 0.058-0.195) of cases. ESD of HR-CANs shows favorable outcomes on the medium and long-term course in IBD patients.

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Gastroenterology

Physiological Data Collected from Wearable Devices Identify and Predict Inflammatory Bowel Disease Flares.

Longitudinally collected physiological metrics from wearable devices can identify and change prior to IBD flares, suggesting their feasibility to monitor and predict IBD activity.

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Gastrointest Endosc

Computer-Assisted Classification of the Squamocolumnar Junction.

Our computer-generated model was capable of auto-segmentation and classification of the z-line. We established a threshold of complexity using wavelet energy coefficient to standardize the classification of the SCJ.

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Endoscopy and Anesthesia Outcomes Associated with Glucagon-Like Peptide-1 Receptor Agonist use in Patients Undergoing Outpatient Upper Endoscopy.

Patients on GLP1RAs have increased rates of solid RGCs during upper endoscopy, but not with concurrent colonoscopy, and higher rates of aborted procedures, but similar rates of adverse anesthesia events.

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Predicting the need for step-up after EUS-guided drainage of peripancreatic fluid collections, including Quadrant Necrosis Infection score validation: a prospective cohort study.

The high-risk QNI group was associated with a significantly longer hospital stay (12 days vs 4 days, p=0.004). EUS tended to upscale the necrotic content compared to preprocedural Radiology (κ=0.31) CONCLUSIONS: The extent of necrosis and the QNI classification strongly correlated with the need for step-up and allocation to LAMS vs DPPS drainage, proposing a central role in treatment personalization.

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The Clinical Utility of Incorporating Next-Generation Sequencing Results in the Management Algorithm of Pancreatic Cysts.

NGS informed surgical decision-making, cyst type differentiation, and evaluation of pancreatic duct dilation, leading to changes in management. Indeed, NGS emerges as a useful tool in select patients with pancreatic lesions by improving diagnostic precision and guiding patient care paths.

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Yield of Esophageal Biopsy Patterns for the Diagnosis of Eosinophilic Esophagitis.

Isolated segmental eosinophilia is common in EoE, including up to 10% non-distal disease. Discordant mid and proximal biopsy findings are prevalent, with no isolated proximal eosinophilia. Standard protocol should include routine biopsies of both distal and middle esophagus to maximize diagnostic yield.

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Gut

Surveillance in inflammatory bowel disease: white light endoscopy with segmental re-inspection versus dye-based chromoendoscopy - a multi-arm randomised controlled trial (HELIOS).

HD white-light endoscopy with segmental re-inspection was non-inferior to HD chromoendoscopy for colorectal neoplasia detection in IBD patients. It can therefore be assumed that the benefit of HD chromoendoscopy may be explained by the longer withdrawal time and not necessarily the enhanced contrast. However, re-inspection per se did not lead to a significantly higher colorectal neoplasia rate than single-pass HD white-light endoscopy alone.

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Targeting MXD1 sensitises pancreatic cancer to trametinib.

Our study has discovered an important mechanism for trametinib resistance and identified MXD1 as a druggable target in treatment of trametinib-resistant PDAC.

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Unlocking novel T cell-based immunotherapy for hepatocellular carcinoma through neoantigen-driven T cell receptor isolation.

These findings offer valuable insights into the functional profiles of neoantigen-reactive T cells within and surrounding the HCC microenvironment. T cells isolated from liver flushes and tumour-draining lymph nodes may serve as a promising source of reactive T cells and TCRs for further use in immunotherapy for HCC.

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Hepatology

Identification of glycogen synthase kinase 3alpha/beta as a host factor required for hepatitis B virus transcription using high-throughput screening.

Our recombinant HBV-based screening system enables the discovery of new targets. Using our approach, we identified GSK3 inhibitors as potential anti-HBV agents.

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Long-term outcome and risk stratification in compensated advanced chronic liver disease after HCV-cure.

Baveno VII criteria to exclude (FU-liver stiffness measurement 3 y). One-time post-treatment risk stratification based on noninvasive criteria provides important prognostic information that is maintained during long-term follow-up, as the hazards remain proportional over time.

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PSC and colitis: A complex relationship.

With this review, we aim to summarize the current knowledge on the gut-liver axis in PSC-IBD, provide new perspectives on risk stratification and treatment and identify gaps in our current knowledge. Our understanding of this complex relationship will therefore help to design clinical trials and shape the future therapy of PSC-IBD.

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TIGIT-expression on natural killer cell subsets is an early indicator of alleviating liver inflammation following bulevirtide treatment in chronic hepatitis D.

We here suggest that lacking the expression of the immune checkpoint inhibitor TIGIT on NK cell subtypes may be a hallmark of liver inflammation in HDV infection. BLV-therapy is associated with a reappearance of TIGIT on these cells, which may be one mechanism of why liver enzymes rapidly improve during therapy.

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J Hepatol

Circulating monocytes upregulate CD52 and sustain innate immune function in cirrhosis unless acute decompensation emerges.

CD52 may represent a biologically relevant target for future immunotherapy. Stabilising CD52 may enhance monocyte functions and infection control in the context of cirrhosis, guided by sCD52/PLC as biomarkers indicating immuneparesis. Impact and implications Monocyte dysfunction substantially contributes to infection susceptibility which determines the prognosis of cirrhosis patients, and represents a critical condition with unmet therapeutic needs. Its underlying mechanisms remain poorly understood, although among hepatologists a better understanding of the monocyte pathophysiology in relation to cirrhosis stages, and a therapeutic reconstitution of monocyte function are believed to enhance defence against infection and thus reduce morbidity and mortality of patients with cirrhosis in the future. By systematically delineating the heterogeneity and function of circulating monocytes ex vivo, we identified that the absence of CD52 expression on monocytes represented a distinct biomarker of monocyte dysfunction in patients with cirrhosis, discriminating patients at substantial risk for infectious complications. Otherwise, given the beneficial antimicrobial functions of CD52-expressing monocytes, CD52-stablisation may also represent such a target for immunotherapy worth exploring, at it has been desired in clinical practise.

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Contrast-enhanced ultrasound-based AI model for multi-classification of focal liver lesions.

The combination of ultrasound device, CEUS examination and Model-DCB enables even patients in remote areas to obtain excellent diagnostic performance through examination by junior radiologists. NCT04682886.

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Genomic and transcriptomic signatures of sequential carcinogenesis from papillary neoplasm to biliary tract cancer.

With the largest IPN/ICPN cohort reported to date, our study provides a genome- and spatial transcriptome-level portrait of sequential carcinogenesis and differences in the anatomical location of biliary papillary neoplasms. Impact and implications Biliary tract cancer is a fatal malignancy. However, its genome-level sequential carcinogenesis from intraepithelial neoplasia to carcinoma has not yet been evaluated in a sufficiently large cohort. Papillary lesions of the bile duct and gallbladder are collectively termed intraductal papillary neoplasms (IPN) of the bile duct and intracholecystic papillary neoplasms (ICPN), respectively. They are primarily diagnosed based on histopathological studies. This study provides a comprehensive mutational and spatial transcriptomic landscape of papillary neoplasms of the bile duct and gallbladder. The results of this study offer insights into the mechanism of sequential carcinogenesis in papillary biliary tract tumors, pathology-genomics correlation, and potential therapeutic targets.

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Modeling the Health and Economic Impact of Pharmacologic Therapies for MASLD in the United States.

Increasing diagnosis and treatment for the MASLD population with moderate-to-advanced fibrosis will prevent advanced liver disease and death and will result in reducing the associated direct healthcare costs. Increasing awareness, screening and diagnosis along with introducing pharmacologic therapies that halt fibrosis progression are necessary to realize health and economic benefits for the MASLD population. Impact and implications MASLD, the most rapidly increasing and prevalent liver disease, leads to chronic liver disease which generates substantial health care costs. As disease burden and costs mount, pharmacologic therapy which halts MASLD fibrosis progression is coming to fruition. Modeling the impact on disease progression of a hypothetical pharmacologic therapy which halts MASLD fibrosis progression through multiple scenarios provides insights into the key drivers of the disease and costs associated with it to facilitate best policies and practices to mitigate the burden of MASLD.

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Pan-PPAR agonist lanifibranor improves insulin resistance and hepatic steatosis in patients with T2D and MASLD.

Lanifibranor significantly improves hepatic, muscle and adipose tissue insulin resistance. Lanifibranor treatment was safe and effective in reducing hepatic steatosis and cardiometabolic risk factors associated with metabolic dysfunction. Impact and implications No prior studies have evaluated the effect of lanifibranor on insulin sensitivity at the level of muscle, liver and adipose tissue and its relationship to changes in intrahepatic triglyceride (IHTG) content in insulin resistant subjects with MASLD and T2D. We observed a significant decrease in IHTG after 24 weeks of treatment (by ∼50%, p < 0.001 versus placebo) that was associated with a major improvement in hepatic and peripheral (Rd) insulin sensitivity, restoration of adipose tissue function with more than two-fold increase in plasma adiponectin concentration and improvement in cardiometabolic risk factors. This is the first in-depth study on how a pan-PPAR approach reverses steatosis and metabolic dysfunction in patients with T2D and MASLD. It has important clinical implications because it offers proof-of-concept that by targeting the key underlying metabolic defects in MASLD (i.e., insulin resistance, lipotoxicity and hyperglycemia) one can restore cardiometabolic health and offers a compelling rationale for treating with lanifibranor individuals with MASLD, either alone or in combination with weight loss and other treatment strategies. Clinicaltrials Gov identifier NCT03459079.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: Safety and Effects of Direct Oral Anticoagulants for Portal Vein Thrombosis.

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Editorial: Steatotic Liver Diseases Emerge as Rapidly Growing Drivers of Primary Liver Cancer in the United States.

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PCAB Safety: Balancing Potential Long-Term Risks With Short-Term Benefits.

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Gut

Metabolic dysfunction-associated steatotic liver disease in children.

MASLD is a complex disease affecting one in ten children and is associated with increased early mortality risk. More dedicated studies are needed in children to advance our understanding of this disease and find effective treatments.

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J Hepatol

Introducing the Breakthrough Beyond the Journal series.

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Reading through circular RNAs in MASLD: new diagnostic and therapeutic opportunities may come around.

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The Journal of Hepatology: A new team at 40.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Giant Sister Mary Joseph`s nodule in Hepatocellular Carcinoma.

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Endoscopy

A novel loop-head guidewire-assisted endoscopic retrograde appendicitis therapy for fecalith obstruction.

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A novel technique for colonic diverticular bleeding hemostasis using hemostatic forceps and the reopenable-clip over-the-line method.

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Don't be overconfident about the "cover" of a covered self-expandable metal stent in endoscopic ultrasound-guided hepaticogastrostomy.

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Endoscopic septum division to resolve nonstenotic gastric outlet obstruction after endoscopic submucosal dissection of the gastric antrum.

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Ileocecal stent placement for malignant obstruction using a side-viewing endoscope and a balloon-equipped overtube.

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Intravaginal endoscopic vacuum therapy of a rectovaginal fistula: expanding boundaries.

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Management of a fractured and retained plastic stent during endoscopic ultrasound-guided hepaticogastrostomy.

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Novel hemostatic gel and powder as rescue agents for arterial bleeding related to lumen-apposing metal stent placement.

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Slip-knot thread method for performing anchor-wire technique to prevent proximal dislocation of preceding stent in placement of multiple biliary inside plastic stents.

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Successful hemostasis of colonic diverticular bleeding using single-balloon-assisted endoscopy and endoscopic band ligation in a patient with difficult total colonoscopy.

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Successful resection of a large adenoma of the descending duodenum by endoscopic submucosal dissection.

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Technical tip: endoscopic internalization by cutting the drainage tube after endoscopic ultrasound-guided naso-gallbladder drainage for acute cholecystitis.

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The usefulness of cholangioscopy in the diagnosis of peribiliary cysts: a case report.

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Three-point traction functions like full-face traction: facilitating rapid excision of a laterally spreading tumor.

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Treatment of thoracogastric-mediastinal-pleural-airway fistula with esophageal stent, vascular plug, and tissue glue.

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Gastroenterology

AGA Institute Quality Indicator Development for Irritable Bowel Syndrome.

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Gastrointest Endosc

A lumen-apposing metal stent for diarrhea?

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Budesonide MMX for prevention of colonic stricture after subcircumferential endoscopic submucosal dissection.

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Cholangioscopy-assisted secondary duodenal stent placement in a patient with duodenal obstruction after duodenal stent insertion.

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ERCP for choledocholithiasis in a patient with Situs Inversus presenting with abdominal pain.

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Endoscopic dissection of an esophageal stent.

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Endoscopic submucosal excavation for ileal lipoma (with video).

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First Documented Case: ERCP Detection of Right Hepatic Duct-Duodenal Fistula Post-Billroth II Gastrectomy.

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Laparoscopic endoscopic cooperative surgery for fixed and folded rectal stricture in Crohn's patient.

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Successful One-Time Removal of Nearly One Hundred Intrahepatic and Extrahepatic Bile Ducts Stones with Endoscopic Sphincterotomy in a Short Time.

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Top linear incision:a modified endoscopic submucosal excavation for the management of cardiac subepithelial leiomyoma.

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Gut

An unusual cause of oesophageal stricture.

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Challenge of treatment de-escalation in inflammatory bowel diseases.

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Hepatology

An unmet need in MetALD.

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BileMet: A new frontier in distinguishing malignant from benign biliary conditions.

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Dynamic duo: Spleen stiffness and bilirubin revolutionize PSVD screening.

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Hide and Seek: Detecting HCC with novel surveillance algorithms.

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Late Breaking Abstracts.

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Non-Invasive liver disease assessment using Blood- and Imaging-Based techniques.

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The impact of LRP4 mutations on hepatocellular carcinoma recurrence and immunotherapy response.

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Unveiling the immune landscape of IDH1-mutant cholangiocarcinoma: Pathways to new therapies.

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J Hepatol

Antiviral treatment of chronic hepatitis D virus infection: To combine or not to combine?

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From the Editor's Desk...

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From the Editor's Desk...

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Tertiary lymphoid structure dynamics at the centre of immunotherapy response in hepatocellular carcinoma.

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Why weight loss is only half the battle: The epigenetic memory of adipose tissue.

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Zonal control of liver inflammation is orchestrated by periportal kupffer cells.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Steatotic Liver Diseases Emerge as Rapidly Growing Drivers of Primary Liver Cancer in the United States-Author's Reply.

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Letter: Addressing Gaps in Hospital-Based Hepatitis C Screening-Insights and Recommendations.

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Letter: Enhancing HCC Surveillance-GES Represents an Innovative Simple Effective Tool for Risk Stratification, Patient Safety and Reduced Anxiety.

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Letter: Enhancing HCC Surveillance: GES Score Represents an Innovative Simple Effective Tool for Risk Stratification, Patient Safety and Reduced Anxiety-Authors' Reply.

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Letter: Toward Intra-Class Switching With JAK Inhibitors?

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Letter: Toward Intra-Class Switching With JAK Inhibitors? Authors' Reply.

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Gastroenterology

Critical Reflections on Tumor Microenvironmental Alterations in Peritoneal Metastases.

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Pouch Crohn's-like Disease: Mucosal Single-Cell Profiling Uncovers Pathogenesis and Targets.

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Regarding the AGA Clinical Practice Update on Integrating Vonoprazan Into Clinical Practice.

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J Hepatol

Leveraging normothermic liver machine perfusion as a platform for oncologic assessment in cirrhotic livers.

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On the need for an adult-to-adult liver graft split policy-An appraisal.

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